Aspectos claves sobre el síndrome de Trousseau

Santiago Castañeda Palacio, Lina María Martínez Sánchez, Sebastián Cerón Luna, José Manuel Gil Ramos

Texto completo:

PDF

Resumen

Introducción:

El síndrome de Trousseau es paraneoplásico, este incrementa el riesgo de trombosis. Además, la enfermedad cerebrovascular es común entre los pacientes con cáncer, se presenta hasta en un 15 % durante el curso clínico.

Objetivo:

Abordar los aspectos claves, sobre el tema del Síndrome de Trousseau.

Métodos:

Se realizó la búsqueda de información en las bases como: PubMed, Science-Direct, Scielo, Lilacs, Embase, Ebsco, con términos como tromboembolias venosa y pulmonar. Se identificó que en los embolismos venoso o arterial la ultrasonografía Doppler, fue útil para el diagnóstico. La estrategia del tratamiento se basó en heparina, aunque se pudieron presentar complicaciones como la trombosis asociada a los catéteres.

Conclusión:

Este síndrome paraneoplásico, incrementa el riesgo de la trombosis que se relaciona con eventos arteriales y venosos. El tratamiento principal es con heparina de bajo peso molecular, no fraccionada o fondaparinux.

 

Palabras clave

adenocarcinoma de pulmón, trombosis venosa, anticoagulantes, embolismo pulmonar

Referencias

Lee SW, Tanaka R, Imai Y, Kuwabara H, Hirose Y, Uchiyama K. Trousseau's syndrome associated with rapidly emerging pancreatic adenocarcinoma soon after esophagectomy: a case report. Int J Surg Case Rep[Internet].2020[citado 1 Ago 2023];77:605-609. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708758/

Ciuffini LA, Wang TF, Lodigiani C, Carrier M. Thromboprophylaxis of cancer patients undergoing systemic therapy in the ambulatory setting. Best Pract Res Clin Haematol.2022;35(1):101351. doi:https://doi.org/10.1016/j.beha.2022.101351

Campello E, Bosch F, Simion C, Spiezia L, Simioni P. Mechanisms of thrombosis in pancreatic ductal adenocarcinoma. Best Pract Res Clin Haematol. 2022;35(1):101346. doi: https://doi.org/10.1016/j.beha.2022.101346

Colla P, Pappolla A, Alonzo C, Brescacin L, Heriz A, Horsch A, et al . Accidente cerebrovascular isquémico en pacientes con cáncer. Un estudio caso-control. Medicina (B. Aires) [Internet]. 2020 [citado 1 Ago 2023 ] ; 80( 5 ): 442-6. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S002576802020000700442&lng=es.

Chen Y, Zhang C, Wang X, Han L, Zhu S, Liu Y, et al. Suitability of Thrombolysis for Patients With Acute Ischemic Stroke Complicated With Trousseau Syndrome. Front Neurosci[Internet]. 2020 [citado 1 Ago 2023 ];14:481. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303462/

Ikeda H, Enatsu R, Yamana N, Nishimura M, Saiki M. Multiple extra-ischemic hemorrhages following intravenous thrombolysis in a patient with Trousseau syndrome: case study. Springerplus[Internet]. 2015[citado 1 Ago 2023 ];4:141. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375212/

Tirandi A, Preda A, Carbone F, Montecucco F, Liberale L. Pulmonary embolism in patients with cancer: An updated and operative guide for diagnosis and management. Int J Cardiol. 2022;358:95-102. doi: https://doi.org/10.1016/j.ijcard.2022.04.068

Okada S, Miyagawa-Hayashino A, Fujinami J, Nishimura T, Ishikawa N, Tsunezuka H, et al. Trousseau's syndrome associated with pulmonary pleomorphic carcinoma exhibiting aggressive features: A case report. Mol Clin Oncol[Internet]. 2020[citado 1 Ago 2023 ];12(1):36-40. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888249/

García E, Borrego E , Morales R, Díaz L, Garrido L, A Sancho. Ictus isquémico por síndrome de Trousseau como primera manifestación de un adenocarcinoma renal. Diálisis y Trasplante[Internet].2019[citado 1 Ago 2023];40(2):35-7. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7171550

Itzhaki Ben Zadok O, Spectre G, Leader A. Cancer-associated non-bacterial thrombotic endocarditis. Thromb Res[Internet].2022[citado 1 Ago 2023];213 Suppl 1:S127-S132. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(21)00543-0

Pease N, Noble S. Cancer-associated thrombosis in palliative care. Medicine. 2022;50(12): 789-92. doi: https://doi.org/10.1016/j.mpmed.2022.09.006

Carriel Mancilla J, Jiménez S, Martín-Sánchez FJ, Jiménez D, Lecumberri R, Alonso Valle H, et al. Profiles of patients with venous thromboembolic disease in the emergency department and their medium-term prognosis: data from the ESPHERIA registry. Emergencias[Internet]. 2021[citado 1 Ago 2023];33(2):107-14.Disponible en: https://pubmed.ncbi.nlm.nih.gov/33750051/

Ren R, Yan H, Gui Y, Zhao J, Wang H, Ji D, et al. Clinical Features of Trousseau Syndrome With Cerebral Infarction as the Initial Manifestation. Neurologist[Internet]. 2020 [citado 1 Ago 2023];25(5):117-21. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32925481/

Stoyanov GS, Dzhenkov DL, Tzaneva M. Thrombophlebitis Migrans (Trousseau Syndrome) in Pancreatic Adenocarcinoma: An Autopsy Report. Cureus[Internet]. 2019[citado 1 Ago 2023];11(8):e5528. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31687303/

Tsushima M, Metoki N, Hagii J, Saito S, Shiroto H, Yasujima M, et al. D-dimer and C-reactive Protein as Potential Biomarkers for Diagnosis of Trousseau's Syndrome in Patients with Cerebral Embolism. J Stroke Cerebrovasc Dis. 2020;29(2):104534. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104534

Sato H, Chikuda J, Saito Y, Katsuta H, Yano T, Shimane T. A case of carcinoma of the lower gingiva with thrombosis in the flap at the collection of the vascularized fibular flap and postoperative subendocardial infarction. Oral Maxillofacial Surgery Cases. 2022;8(1):100245. doi: https://doi.org/10.1016/j.omsc.2022.100245

Tanimura J, Yamamoto T, Hashimoto T. Clinical features and prognostic factors in patients with cancer-associated multiple ischemic stroke: A retrospective observational study. J Stroke Cerebrovasc Dis. 2022;31(12):106813. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106813

Bao L, Zhang S, Gong X, Cui G. Trousseau Syndrome Related Cerebral Infarction: Clinical Manifestations, Laboratory Findings and Radiological Features. J Stroke Cerebrovasc Dis. 2020;29(9):104891. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104891

Grilz E, Königsbrügge O, Posch F, Schmidinger M, Pirker R, Lang IM, Pabinger I, Ay C. Frequency, risk factors, and impact on mortality of arterial thromboembolism in patients with cancer. Haematologica[Internet]. 2018[citado 1 Ago 2023];103(9):1549-56. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119137/

Lun R, Siegal D, Ramsay T, Dowlatshahi D. Cancer and stroke: What do we know and where do we go? Thromb Res. 2022;219:133-140. doi: https://doi.org/10.1016/j.thromres.2022.09.014

Wang J, Kim YD, Kim CH. Incidence and Risk of Various Types of Arterial Thromboembolism in Patients With Cancer. Mayo Clin Proc. 2021;96(3):592-600. doi: https://doi.org/10.1016/j.mayocp.2020.05.045

Noumegni SR, Didier R, Mansourati V, Tromeur C, Le Moigne E, et al. Risk factors of arterial thrombotic events after unprovoked venous thromboembolism, and after cancer associated venous thromboembolism: A prospective cohort study. Thromb Res. 2022;214:93-105. doi: https://doi.org/10.1016/j.thromres.2022.04.016

Bellido Casadoa J, Carretero Sastrea JL, Recio Ruedab I, Smucler Simonovichb A, Torres Nieto MA. Síndrome de Trousseau en adenocarcinoma de pulmón. La infrecuente aparición de la gangrena venosa. Archivos de Bronconeumología. 1997;33(6):312-314. doi: https://doi.org/10.1016/S0300-2896(15)30603-7

.

Nakano Y, Koide N, Koyama Y, Nitta K, Koizumi T. Lung adenocarcinoma initially presenting as Trousseau's syndrome treated successfully with pembrolizumab: A case report. Thorac Cancer[Internet]. 2021[citado 1 Ago 2023];12(4):557-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882382/

Barg AA, Kenet G. Cancer-associated thrombosis in pediatric patients. Thromb Res. 2020;191 (Suppl 1):S22-S25. doi: https://doi.org/10.1016/j.beha.2022.101352

Tawil N, Rak J. Blood coagulation and cancer genes. Best Pract Res Clin Haematol. 2022;35(1):101349. doi: https://doi.org/10.1016/j.beha.2022.101349

Sharman Moser S, Spectre G, Raanani P, Friedman-Mazursky O, Tirosh M, Chodick G, et al. Cancer-associated venous thromboembolism in Israel: Incidence, risk factors, treatment, and health care utilization in a population based cohort study. Res Pract Thromb Haemost[Internet]. 2022[citado 1 Ago 2023];6(4):e12653. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126988/

Hakami A. World Cancer 2019: Trousseau'S Syndrome in Association with Lung Adenocarcinoma. AM J Respr Crit Care Med[Internet]. 2019[citado 1 Ago 2023];3(1):. Disponible en: https://www.rroij.com/open-access/world-cancer-2019-trousseaus-syndrome-in-association-with-lung-adenocarcinomaabdulrahman-hakami-jazan-university.pdf

Falanga A, Brenner B, Khorana AA, Francis CW. Thrombotic complications in patients with cancer: Advances in pathogenesis, prevention, and treatment-A report from ICTHIC 2021. Res Pract Thromb Haemost[Internet]. 2022[citado 1 Ago 2023];6(5):e12744. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9248072/

Yuan T, Wang J. Clinical and Imaging Features of Acute Cerebral Infarction in Non-small Cell Lung Cancer Patients with Trousseau Syndrome. Zhongguo Fei Ai Za Zhi[Internet].2021 [citado 1 Ago 2023];24(1):13-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849036/

Ema T, Neyatani H, Mochizuka Y, Yasuda K, Yamamoto S, Iizuka S, et al. Salvage surgery for primary lung cancer complicated with Trousseau's syndrome after chemotherapy: a case report. AME Case Rep[Internet]. 2020 [citado 1 Ago 2023];4:3. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082236/

Wang HY, Wu SG, Lin YT, Chen CY, Shih JY. Risk of thromboembolism in non-small-cell lung cancers patients with different oncogenic drivers, including ROS1, ALK, and EGFR mutations. ESMO Open. 2022;7(6):100742. doi: https://doi.org/10.1016/j.esmoop.2022.100742

Lin M, Lu Y, Yu Q, Chen Z, Peng J, Cai X. Common genetic driver mutation in NSCLC and their association with thromboembolic events: A retrospective study. Lung Cancer. 2022;172:29-34. doi: https://doi.org/10.1016/j.lungcan.2022.06.011

Franco-Moreno A, Cabezón-Gutiérrez L, Palka-Kotlowsa M, Villamayor-Delgado M, García-Navarro M. Evaluation of direct oral anticoagulants for the treatment of cancer-associated thrombosis: an update. J Thromb Thrombolysis[Internet].2019[citado 1 Ago 2023];47(3):409-19. Disponible en: https://link.springer.com/article/10.1007/s11239-018-1783-2

Hakoum MB, Kahale LA, Tsolakian IG, Matar CF, Yosuico V, Terrenato I et al. Anticoagulation for the initial treatment of venous thromboembolism in people with cancer. Cochrane Database Syst Rev[Internet]. 2018[citado 1 Ago 2023];1(1):CD006649. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389339/

Lozano S, Velasco p, Zarco p, Salvador R. Los anticoagulantes orales directos en el tratamiento de la enfermedad tromboembólica venosa asociada a cáncer. Evidencias y recomendaciones. Angiología [Internet]. 2022 Abr [citado 2 Ago 2023 ] ; 74( 2 ): 51-65. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0003-31702022000200051&lng=es.

Becattini C, Di Nisio M, Franco L, Lee A, Agnelli G, Mandalà M. Treatment of venous thromboembolism in cancer patients: The dark side of the moon. Cancer Treat Rev. 2021;96:102190. doi: https://doi.org/10.1016/j.ctrv.2021.102190

Sardiña González C, Martínez Vivero C, López Castro J. Paraneoplastic syndromes review: The great forgotten ones. Crit Rev Oncol Hematol. 2022;174:103676. doi: https://doi.org/10.1016/j.critrevonc.2022.103676

Kewan T, Ko T, Flores M, Sallam Y, Haddad A, Daw H. Prognostic impact and risk factors of cancer-associated thrombosis events in stage-IV cancer patients treated with immune checkpoint inhibitors. Eur J Haematol[Internet]. 2021[citado 2 Ago 2023 ] ; 106(5):682-88. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/ejh.13598

Elgendy IY, Fogerty A, Blanco-Molina Á, Rosa V, Schellong S, Skride A, et al. Clinical Characteristics and Outcomes of Women Presenting with Venous Thromboembolism during Pregnancy and Postpartum Period: Findings from the RIETE Registry. Thromb Haemost[Internet]. 2020[citado 2 Ago 2023 ];120(10):1454-62. Disponible en: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1714211

Perilla S. Caracterización clínica de pacientes con enfermedad tromboembólica asociada a cáncer en el Instituto Nacional de Cancerología. [ITesis]. Bogotá: Universidad Nacional de Colombia Sede Bogotá Facultad de Medicina Departamento de Medicina Interna; 2018. [citado 2 Ago 2023 ]. Disponible en: https://repositorio.unal.edu.co/handle/unal/62885

Zalatnai A, Perjési E, Galambos E. Much More than Trousseau Syndrome. The Broad Spectrum of the Pancreatic Paraneoplastic Syndromes. Pathol Oncol Res[Internet]. 2018[citado 2 Ago 2023 ];24(1):1-10. Disponible en: https://link.springer.com/article/10.1007/s12253-017-0206-6

Alfonso-Simón A, Inguanzo-Valdés I. Síndrome de Trousseau como manifestación de neoplasias malignas. Investigaciones Medicoquirúrgicas [Internet].2020 [citado 2 Ago 2023]; 12 (1):1-15 Disponible en: https://revcimeq.sld.cu/index.php/imq/article/view/584

Adess M, Eisner R, Nand S, Godwin J, Messmore Jr HL, Wehrmacher WH. Thromboembolism in cancer patients: pathogenesis and treatment. Clin Appl Thromb Hemost[Internet]. 2006[citado 2 Ago 2023];12(3):254–66.Disponible en: https://pubmed.ncbi.nlm.nih.gov/16959679/

Ando T, Watanabe K, Nakayama R, Mizusawa T, Sakai T, Katagiri A. Trousseau's syndrome manifesting as multiple cerebral infarctions caused by bladder cancer. Urol Case Rep. 2019;24:100884. doi: https://doi.org/10.1016/j.eucr.2019.100884

Enlaces refback

  • No hay ningún enlace refback.


Copyright (c) 2023 Santiago Castañeda Palacio, Lina María Martínez Sánchez, Sebastián Cerón Luna, José Manuel Gil Ramos

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.